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Efficacy of flow restrictors in limiting access of liquid medications by young children
Maribeth C Lovegrove1, Stephanie Hon, Robert J Geller
1Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
Insights
Flow restrictors (FRs) significantly reduce unsupervised liquid medicine ingestion by young children. Adding FRs to bottles offers enhanced protection, even if child-resistant caps are not fully secured.
Area of Science:
- Pediatric safety
- Consumer product safety
Background:
- Unsupervised ingestion of liquid medications by young children poses a significant safety risk.
- Child-resistant packaging is a primary safety measure, but its effectiveness can be compromised if not fully secured.
Purpose of the Study:
- To evaluate the efficacy of flow restrictors (FRs) in preventing unsupervised medication access by young children.
- To determine if FRs provide additional safety benefits beyond standard child-resistant closures.
Main Methods:
- A randomized trial involved 110 children aged 3-4 years attempting to access liquid from bottles.
- Test bottles included uncapped versions with FRs and control bottles without FRs (uncapped or incompletely closed).
- Children's ability to remove liquid within a 10-minute period was measured.
Main Results:
- Bottles with FRs were significantly less likely to be emptied compared to control bottles (6% vs. 82-96% emptied).
- Children removed substantially less liquid from bottles with FRs (P < .001).
- A higher percentage of children removed less than 25 mL from bottles with FRs compared to controls.
Conclusions:
- Flow restrictors (FRs) effectively limit young children's access to liquid medications.
- FRs can serve as a valuable complementary safety feature to existing child-resistant packaging for liquid medicine bottles.
Objective:
To assess whether adding flow restrictors (FRs) to liquid medicine bottles can provide additional protection against unsupervised medication ingestions by young children, even when the child-resistant closure is not fully secured.
Study Design:
In April and May 2012, we conducted a block randomized trial with a convenience sample of 110 3- and 4-year-old children from 5 local preschools. Participants attempted to remove test liquid from an uncapped bottle with an FR and a control bottle without an FR (with either no cap or an incompletely closed cap).
Results:
All but 1 (96%; 25 of 26) of the open control bottles and 82% (68 of 83) of the incompletely closed control bottles were emptied within 2 minutes. Only 6% (7 of 110) of the bottles with FRs were emptied during the 10-minute testing period, none before 6 minutes. Overall, children removed less liquid from the bottles with FRs than from the open or incompletely closed control bottles without FRs (both P < .001). All children assigned open control bottles and 90% of those assigned incompletely closed control bottles removed ≥ 25 mL of liquid. In contrast, 11% of children removed ≥ 25 mL of liquid from uncapped bottles with FRs. Older children (aged 54-59 months) were more successful than younger children at removing ≥ 25 mL of liquid (P = .002) from bottles with FRs.
Conclusion:
Our findings suggest that adding FRs to liquid medicine bottles limits the accessibility of their contents to young children and could complement the safety provided by current child-resistant packaging.
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